Sources of SARS-Cov-2 and Other Microorganisms in Dental Aerosols

Dr. Purnima Kumar
Periodontist and Professor in the Division of Periodontology
The Ohio State University College of Dentistry
Senior Co-Author: Sources of SARS-Cov-2 and Other Microorganisms in Dental Aerosols

When dental practices were shut down a little over a year ago, Dr. Purnima Kumar, periodontist and Professor in the Division of Periodontology at The Ohio State University College of Dentistry, had a question: what evidence is there in the literature that aerosols generated by dental procedures can transmit pathogens?

In the subsequent weeks of lockdown, she and her husband, an endodontist, spent their time combing the journals for relevant studies. And though they found several studies to show that dental instruments generate aerosols, there were only a handful that actually looked at what type of bacteria were present in the aerosols. More importantly, nobody had asked what the source of the bacteria was.

On return from lockdown, she set up an IRB protocol to look at the source of bacteria in aerosol generating dental procedures, collecting samples from the face shields of the operator, the assistant, the patient’s chest, and from a dental counter six feet from the patient. She and her research group also collected saliva samples from the patient and samples from the irrigant.

In this conversation with Chiraz Guessaier, Manager CDA Oasis, Dr. Kumar walks through the methodology and key findings of her study, and suggests that based on the initial evidence, dental aerosols are not a primary source of pathogens carried in the saliva.

Here are some the highlights from the study…

• Most bacteria found on the operator’s face shield, the assistant’s face shield, and the dental counter were coming from the irrigant and not the saliva.
• Some bacteria from the saliva were found on the patient’s chest.
• Out of 8 patients whose samples showed bacteria from saliva, 5 of them had not used hydrogen peroxide mouthwash.
• A good number of patients in the study were found to be asymptomatic carriers of SARS-CoV-2 in their saliva, yet when high volume suction and hydrogen peroxide mouthwash were used, SARS-CoV-2 was not detected in any aerosol sample.

Conclusions

• When using high volume suction and hydrogen peroxide rinse, the risk of spreading SARS-CoV-2 through dental aerosols is very low.
• However, dental aerosol generation is only one part of the procedure. There are many other potential sources of disease transmission in the dental office such as examining the patient, talking, coughing, sneezing etc.
• More studies are needed, but initial evidence points towards dental aerosols as not being a primary source of pathogens carried in the saliva.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team

Resource
Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols (PubMed)

Full Conversation (19.06")